Posted by: Dr Susie Bayley24 March 2016
We had to do the unspeakable recently. Request an emergency home visit. I am sorry reader, I cannot describe the ongoing guilt I feel about this.
Things hadn’t been right for a while. Sure it was old, and I’m not sure previous procedures had been done adequately. Movements led to strange noises. But that day, that fateful day, it just gave up.
Could we inconvenience someone for our wants and not needs?
‘It’s making a really funny noise Mummy,’ shouted my son. I rushed to see what he meant. A buzzing could be heard, then a clunk and then… silence.
‘Well, it was pretty old,’ said my surgical husband, ’perhaps if we give it a wollop’.
‘NO!’, I shrieked, I hadn’t had time to ascertain its ideas, concerns and expectations, let alone do an advanced care plan.
We needed help, we weren’t experts, a generalist and an orthopod: we were working outside of our competencies. Neither of us had even completed a DOPS in this field. ‘We need an expert who can sort out the waterworks’, I said.
‘Ah’ said my husband, ‘you mean a urologist?’.
I answered: ‘No darling, a plumber’.
It was a Saturday, it was the holidays and we had no hot water, nor heating. We looked at one another, was this really an emergency? Could we inconvenience someone for our wants and not needs?
‘Think of the children,’ I pleaded, after bribing the kids to do their best ‘street urchin’ impressions.
As they looked at their Daddy, forlorn and shivering, my husband nodded. ‘Make the call,’ he said. The kids winked to each other, I subtly handed over two bags of Haribo.
I rang, prepared for the referral, and possible rejection: ‘Hi, I’ve got an elderly patient, who is hypothermic and seems to have some sort of hot water retention, problem’.
‘What?’ was the irritated reply.
’My water tank’s buzzing and doesn’t work, can you mend it pretty please,’ I paused, and hung my head in shame, ‘And… I’ll need a home visit’. I waited, anticipating the disgust at the other end of the phone, the criticism of my inappropriate request.
‘You’re sure you need it done as an emergency, love?’ he said, ‘it doesn’t matter, to me, it’ll just cost you a more, a lot more’.
So that day our elderly water tank was told it didn’t need a DNAR, but was fixed. We had an emergency home visit by a skilled professional on our terms and my wallet was considerably lighter for it. Could we have waited? Perhaps, but when the payment is commensurate to the inconvenience and skill of the professional involved, that professional really doesn’t mind.
I can’t help feeling we are missing a trick.
Dr Susie Bayley is a GP in Derby and chair of GP Survival